Factors influencing adolescent access to and utilisation of sexual and reproductive health services in Namibia's Rundu District include lack of comprehensive SRH services, cultural factors, distance to health facility, insufficient information, stigma, nurses' attitudes, and lack of privacy.
Key Findings
Results
Lack of comprehensive SRH services in many healthcare facilities was identified as a barrier to adolescent access and utilisation of SRH services.
Data were collected from 15 nurse respondents in primary healthcare facilities in Rundu District, Kavango East Region, Namibia.
The study used a qualitative, explorative approach with semi-structured interviews.
Nurses reported that many facilities did not offer a full range of SRH services needed by adolescents.
This finding emerged through thematic analysis of verbatim transcripts from audio-recorded interviews.
Results
Cultural factors were identified by nurses as a significant influence on adolescents' access to and utilisation of SRH services.
Cultural factors emerged as one of the key themes from thematic analysis of 15 nurse interviews.
The study was conducted in the Kavango East Region, where specific cultural norms may affect adolescent health-seeking behavior.
Cultural influences were reported as shaping adolescents' willingness to seek SRH services.
This was identified through nurse respondents' perspectives in semi-structured interviews.
Results
Distance to health facilities was reported as a barrier preventing adolescents from accessing SRH services.
Nurses identified geographic distance as a contributing factor to low utilisation among adolescents in the Rundu District.
The rural setting of the Kavango East Region likely exacerbates challenges related to physical access.
Distance was one of seven identified factors emerging from thematic analysis of nurse interviews.
The finding was drawn from a convenience sample of 15 nurses working in primary healthcare facilities.
Results
Insufficient information about available SRH services was identified as a factor limiting adolescent utilisation.
Nurses reported that adolescents frequently lacked awareness of what SRH services were available at healthcare facilities.
This knowledge gap was identified as a distinct barrier separate from other structural or cultural factors.
The finding emerged from semi-structured interviews with 15 nurse respondents.
Insufficient information was one of seven barrier themes identified through thematic analysis.
Results
Stigma was identified by nurses as a factor discouraging adolescents from seeking SRH services.
Stigma was identified as one of the seven key factors influencing adolescent access and utilisation of SRH services.
Nurses' accounts indicated that fear of being judged or labeled discouraged adolescents from visiting healthcare facilities for SRH needs.
Stigma was identified through thematic analysis of audio-recorded, verbatim-transcribed interviews with 15 nurses.
The study was conducted in primary healthcare facilities in Rundu District, Kavango East Region, Namibia.
Results
Nurses' own attitudes toward adolescents seeking SRH services were identified as a barrier to access and utilisation.
Nurse respondents acknowledged that negative or judgmental attitudes from healthcare providers can deter adolescents from seeking SRH care.
This finding is notable as the data source was nurses themselves, suggesting self-awareness of provider-level barriers.
Nurses' attitudes emerged as one of seven barrier themes from thematic analysis.
The sample consisted of 15 nurses selected by convenience sampling from primary healthcare facilities.
Results
Lack of privacy at healthcare facilities was identified as a factor discouraging adolescents from accessing SRH services.
Nurses reported that inadequate privacy within facilities made adolescents reluctant to seek SRH services.
Lack of privacy was one of seven barrier themes identified through thematic analysis.
This structural facility-level factor was identified alongside other individual and cultural barriers.
Data were collected via semi-structured interviews with 15 nurses in Rundu District primary healthcare facilities.
Results
The study identified strategies to improve adolescent access to and utilisation of SRH services as a second major theme.
Two overarching themes emerged from thematic analysis: factors influencing access/utilisation and strategies to improve access/utilisation.
Suggested strategies were informed by nurses' practical experience working in primary healthcare in the Kavango East Region.
The findings are intended to assist Namibia's Ministry of Health and Social Services and stakeholders in developing targeted interventions.
Strategies were identified from the same convenience sample of 15 nurse respondents.
Methods
A qualitative explorative design with convenience sampling of 15 nurses was used to examine SRH service access barriers in Rundu District, Namibia.
Semi-structured interviews were used for data collection, with each interview audio-recorded and transcribed verbatim.
Thematic analysis was used to analyse the data.
The study was conducted in primary healthcare facilities in Rundu District, Kavango East Region, Namibia.
Convenience sampling was used to select the 15 nurse respondents.
The qualitative approach was chosen to explore and describe factors from the perspective of healthcare providers.
What This Means
This research suggests that adolescents in the Rundu District of Namibia face multiple overlapping barriers when trying to access sexual and reproductive health (SRH) services. Researchers interviewed 15 nurses working in local primary healthcare clinics, asking them about what prevents young people from getting the care they need. The nurses identified seven main barriers: many clinics do not offer a full range of SRH services; cultural norms discourage adolescents from seeking help; clinics are too far away for many young people to reach; adolescents often do not know what services are available; stigma makes young people fear judgment; the attitudes of nurses themselves can be off-putting; and clinics lack private spaces where adolescents can feel comfortable discussing sensitive issues.
This research suggests that the problem is not simply one of individual choice but is shaped by both the healthcare system and broader social and cultural forces. Notably, nurses were candid about the role their own attitudes play in deterring young people, pointing to a need for provider training and attitude change alongside physical and structural improvements to facilities.
The study's findings are intended to help Namibia's Ministry of Health and Social Services, along with partner organizations, design practical strategies to make SRH services more accessible and welcoming for adolescents. Addressing barriers such as lack of privacy, negative provider attitudes, and insufficient information could meaningfully improve young people's willingness to seek reproductive health care in similar low-resource, rural settings.
Ashipala D, Katjimune V. (2025). Factors influencing access and utilization of sexual and reproductive health services by adolescents in Namibia: Insights from nurses.. African journal of reproductive health. https://doi.org/10.29063/ajrh2025/v29i1.11